Fibromyalgia is a painful condition in which the body hurts all over.  It is more common in women, and often comes with other problems such as: 

• Stomach acid issues
• Irritable bowels
• Sleep issues
• Depression
• Headaches

Treatment is aimed at managing the symptoms and understanding the disease. Fibromyalgia treatment begins with making an accurate diagnosis, and educating the patient on the best treatment options.

A Team Approach to Treatment

The most effective approach to treatment is attacking the condition with a team of medical professionals consisting of:

• Nurses
• Physical therapists
• A Psychologist
• A Physical Medicine Doctor

A multi-disciplinary approach is helpful to shift the patient away from a perception of helplessness, defeat, and frustration and toward a positive and active lifestyle.  Psychology is beneficial in changing attitudes from defeat and depression to understanding and self-motivation.  Psychologists use a variety of techniques including cognitive behavioral therapy and biofeedback to influence changes.  Physical therapy is necessary to teach the patient to go from being inactive, to exercising.  Nursing is helpful to work with sleep problems, diet, nutrition, and understanding lifestyle and medication issues.

Medications & their Effectiveness

Pharmacologic strategies include prescription and non-prescription medications.  There are three drugs approved for Fibromyalgia, and many others that have limited affects.  The most commonly used drugs that are approved are Cymbalta and Lyrica. They both decrease the sensitivity of the nervous system to excessive signals that influence pain.  Amitriptyline and Nortriptyline at low doses also have similar affects and are helpful with sleep.  Narcotics and anti-inflammatory medications are not effective in management and usually lead to more problems than solutions.

Nonprescription medications have varied success rates and the research is not solid to support their effectiveness. S-adenosine-L-methionine(SAM-e) has been used for joint pain and general pain, and is commonly used in Europe.  Tryptophan and melatonin may improve sleep and help with mood.  Fish oil is felt to help with joint and spine pain, and may help control cholesterol levels.   Glucosamine and chondroitin sulfate have been used to help control joint pain.  These supplements are generally felt to be safe. Whether they are going to be helpful is open to question but they should not cause problems.

Fibromyalgia is best treated by a knowledge team of practitioners, headed by an experienced Physical Medicine pain physician.  The goal of treatment is to improve function and activity level, and manage pain symptoms.  Education and psychological well-being are important.  Fibromyalgia is a real syndrome, when treated appropriately can be successfully managed.